Hurricanes and Storms: From Preparedness to Recovery,

Strategies for a Brighter Future

Wednesday, August 8, 20184:00pm ET/3:00pm CT

Scott Needle, MD, FAAPDavid Schonfeld, MD, FAAPDisaster Preparedness Advisory Council

WEBINAR SPONSORS

OBJECTIVES

1. Recognize situations that pediatricians as well as families are still facing specific to recovery from the 2017 hurricanes.

2. Identify steps that can be taken to improve preparedness for hurricane recovery (for offices as well as patients/families).

3. Outline the common symptoms of adjustment reactions in children and adolescents that may occur in response to a disaster.

4. Describe the timeline for coping over time and the importance of long-term support.

5. Appreciate the importance of professional self-care and list strategies clinicians can use to promote wellness for themselves and colleagues.

6. Outline 5-10 ways that pediatricians can improve outcomes for children and families during disaster recovery.

7. Identify 3 resources to improve pediatric capabilities in hurricane recovery.

TECHNICAL SUPPORT

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PRA CREDITS STATEMENT

• The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

• The AAP designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• This activity is acceptable for a maximum of 1.0 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

• The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.0 hours of Category 1 credit for completing this program.

• This program is accredited for 1.0 NAPNAP CE contact hours of which 0 contain pharmacology (Rx) content, (0 related to psychopharmacology) (0 related to controlled substances), per the National Association of Pediatric Nurse Practitioners (NAPNAP) Continuing Education Guidelines.

CME/MOC

• Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 1 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.

FACULTY

David J Schonfeld, MD, FAAPDirector, National Center for School Crisis and Bereavement

Professor of the Practice, Suzanne Dworak-Peck School of Social Work and Department of Pediatrics, USC and CHLA

Member, American Academy of PediatricsDisaster Preparedness Advisory Council

Insert Photo Here

FACULTY

Scott Needle, MD, FAAPCommunity Pediatrician and Medical DirectorHealthcare Network of Southwest Florida

Member, American Academy of PediatricsDisaster Preparedness Advisory Council

DISCLOSURES

• The presenters have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this activity.

• The presenters do not intend to discuss an unapproved/investigative use of a commercial product/device in this presentation.

2017: HARVEY, IRMA, MARIA

2017: A YEAR OF DISASTERS

137 Major Disaster Declarations• 34 states• Puerto Rico, Virgin Islands

• Hurricanes• Flooding• Wildfires• Mass shootings

THE EFFECTS OF DISASTERS

• Morbidity and mortality

• Economic loss

• Long-term suffering

• Disruption of healthcare

• Economic loss

• Provider stress

GOALS OF RECOVERY

Return to normalcy

Reduce suffering

Promote resiliency

Get back to helping others

RETURN TO OPERATIONS

Space Staff

Stuff Security

Services

COMMUNICATIONS

• Getting the word out

• Services, hours, and locations

• What families can do

VACCINES

• Keep all vials!

• Insurance: spoilage

• Private: return for credit

• VFC: return for exchange

PRACTICE RECOVERY: RESOURCES

• AAP Chapter

• Business insurance

– Material losses

– Loss of income

• Local government, Chamber of Commerce

• Be your own advocate!

WHAT TO EXPECT (WHEN YOU’RE PRACTICING AFTER DISASTER)

• Food

• Water

• Shelter

• Children’s needs

Basic needs

• Medicines

• Equipment

• Functioning

• Flares

Chronic conditions

• Derm

• Respiratory

• Injury

• Exposure

• GI

Acute concerns

THE MEDICAL HOME AND TRANSITIONING FROM RESPONSE TO

RECOVERY

• Normalcy

• Familiarity

• Best healthcare setting

• Coordination of services

• Address the chronic needs of recovery

HOW TO HELP

• Assist and support families

– Individually

– Across the practice

• Anticipate needs and concerns

• Monitor for developments

• Advocate for children

HOW TO HELP

• Care for yourself

• Learn, revise, and prepare

– Preparedness Checklist for Pediatric Practices

– Ensuring the Health of Children in Disasters

Supporting the recovery of

children, families and yourself

David J Schonfeld, MD, FAAPSuzanne Dworak-Peck

School of Social Work and PediatricsUniversity of Southern California and

Children’s Hospital Los AngelesSchonfel@usc.edu

Director, National Center for School Crisis and Bereavementwww.schoolcrisiscenter.org

1-877-536-NCSCB (1-877-536-2722)www.grievingstudents.org

National Center for School Crisis and Bereavement

• I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial products or services discussed in this CME activity

• I do not intend to discuss unapproved/investigative use of commercial product(s)/device(s) in my presentation

National Center for School Crisis and Bereavement

• Cascade of secondary losses and stressors– Relocation– Loss of peer network– Academic failure– New social network – Financial stresses– Parental stress, mental health problems– Marital conflict or domestic violence

• Don’t focus solely on post-traumatic symptoms from the events immediately surrounding the crisis

• Explore how they are coping now in light of current stressors

Range of Reactions to Crisis

National Center for School Crisis and Bereavement

• Sleep problems

• Separation anxiety and school avoidance

• Anxiety and trauma-related fears

• Difficulties with concentration

• Deterioration in academic performance

• Regression

• Depression

• Substance abuse

• Somatization

• Trauma symptoms/post-traumatic stress disorder

Potential Symptoms of Adjustment Reactions

National Center for School Crisis and Bereavement

National Center for School Crisis and Bereavement

A B

C

D E

FG

H

I

A = baseline functioningB = eventC = vulnerable stateD = usual coping mechanisms failE = helplessness, hopelessnessF = improved functioning

G = continued impairmentH = return to baselineI = post-traumatic growth

Adjustment Over Time in Crisis

National Center for School Crisis and Bereavement

Importance of Professional Self-Care

• It is distressing to be with children who are in distress

• It’s critical health care providers find ways to have their own personal needs met and appreciate and address impact of supporting children who are grieving or traumatized

National Center for School Crisis and Bereavement

Supporting Those Most in Need can be Gratifying

• Realistic objectives of purpose of interactions

• Health care providers have skills and resources to provide meaningful assistance

• Health care providers are aware of and have sufficient support to deal with personal impact of work

• Especially difficult in austere environment and when you have other challenges

National Center for School Crisis and Bereavement

Support for Staff

• Organizational support

– Additional support staff

– Modify workload, expectations, schedule

– Supportive supervision

– Professional development

– Employee Assistance Program

• Family and peer support

– Inclusion of spouses/significant others in meetings

– Bring staff together for social reasons – preserve cohesion

– Celebrate successes

National Center for School Crisis and Bereavement

Challenges to Self-Care

• Making time when there is so much to do and everyone needs your help

• Feeling shame or guilt for attending to your own needs

• Assuming others are having less trouble adjusting

• Lack of modeling of professional self-care

National Center for School Crisis and Bereavement

National Center for School Crisis and Bereavementwww.schoolcrisiscenter.org

Coalition to Support Grieving Studentswww.grievingstudents.org

AAP Children and Disasters – www.aap.org/disasters

– Coping and adjustment: www.aap.org/disasters/adjustment

Website Resources

National Center for School Crisis and Bereavement

www.schoolcrisiscenter.org

National Center for School Crisis and Bereavement

www.grievingstudents.org

National Center for School Crisis and Bereavement

For further information about NCSCB

visit us, call us, like us, share us:

facebook.com/schoolcrisisorg

@schoolcrisisorg

National Center for School Crisis and Bereavement

www.SchoolCrisisCenter.org | info@schoolcrisiscenter.org

1-888-53-NCSCB (1-888-536-2722)

RESOURCES

• AAP Children & Disasters Web Site (www.aap.org/disasters)

• AAP Hurricane Preparedness Web Page (www.aap.org/disasters/hurricane)

• AAP Hurricane Response and Recovery Web Page (www.aap.org/disastersrecovery)

CME/MOC CREDIT

• Complete the post activity survey.

• Only physicians can claim MOC Part 2 credit. A quiz for MOC Part 2 credit will be included in the post activity survey.

• Physicians must identify their ABP ID number.

AAP staff will email each person claiming CME/MOC 2 credit with their certificate of completion. Email DisasterReady@aap.org with any questions.

QUESTIONS?

Please e-mail DisasterReady@aap.org to receive info on future events, or follow-up as needed.